Online mindfulness therapy may help manage depression: JAMA Psychiatry
USA: The use of online version of mindfulness-based cognitive therapy in addition to the usual depression care (UDC) significantly improved depressive symptoms compared to the use of UDC alone, a recent study in the journal JAMA Psychiatry has suggested.
The findings support the value of online mindfulness-based cognitive therapy -- Mindful Mood Balance (MMB) -- as an adjunctive, scalable approach for the management of residual depressive symptoms.
Due to the availability of limited resources for managing the lingering effects of their illness, patients with residual depressive symptoms face a gap in care. Zindel V. Segal, University of Toronto Scarborough, Toronto, Ontario, Canada, and colleagues evaluated the effectiveness for treating residual depressive symptoms with Mindful Mood Balance, a web-based application that delivers mindfulness-based cognitive therapy, plus usual depression care compared with usual depression care only.
This randomized clinical trial consisted of 460 people with residual depressive symptoms. It was conducted in primary care and behavioral health clinics at Kaiser Permanente Colorado, Denver. A total of 230 patients received usual care, while 230 patients received MMB along with usual care. The MMB treatment included 8 online sessions for a 3-month interval along with minimal phone or email coaching support.
Primary outcomes included reduction in residual depressive symptom severity that was assessed using the Patient Health Questionaire-9 (PHQ-9); rates of depressive relapse (PHQ-9 scores ≥15); and rates of remission (PHQ-9 scores <5). Secondary outcomes included depression-free days, anxiety symptoms (General Anxiety Disorder–7 Item Scale), and functional status (12-Item Short Form Survey).
The investigators identified adults with residual depressive symptoms between March 2015 and November 2018. Outcomes were assessed for a 15-month period, comprising of a 3-month intervention interval and a 12-month follow-up period.
Key findings of the study include:
- Participants who received MMB plus UDC had significantly greater reductions in residual depressive symptoms than did those receiving UDC only (mean [SE] PHQ-9 score, 0.95).
- A significantly greater proportion of patients achieved remission in the MMB plus UDC group compared with the UDC only group (PHQ-9 score, <5), and rates of depressive relapse were significantly lower in the MMB plus UDC group compared with the UDC only group (hazard ratio, 0.61).
- Compared with the UDC only group, the MMB plus UDC group had decreased depression-free days (mean [SD], 281.14 days vs 247.54 days), decreased anxiety (mean [SE] General Anxiety Disorder–7 Item Scale score, 1.21), and improved mental functioning (mean [SE] 12-Item Short Form Survey score, −5.10), but there was no statistically significant difference in physical functioning.
"MMB+UDC significantly improved depression and functional outcomes compared with UDC only. The MMB web-based treatment may offer a scalable approach for the management of residual depressive symptoms," concluded the authors.
The study, "Outcomes of Online Mindfulness-Based Cognitive Therapy for Patients With Residual Depressive Symptoms: A Randomized Clinical Trial," is published in the journal JAMA Psychiatry.
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